Gotcha F’s improved version of “To test or not to test?”

Written by Huib, published Friday September 22nd, 2017

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A group of anonymous authors who call themselves ‘Gotcha F’ – “Scientists United Against Anti-Science Shills” – improved the original article “To test or not to test? Laboratory support for the diagnosis of Lyme borreliosis”, by making it more honest. This is the abstract of their improved version, which circulated on Social Media soon after the original publication on September 5, 2017.

BACKGROUND

Lyme borreliosis (LB) is a tick-borne infection caused by Borrelia burgdorferi sensu lato. Some believe the most frequent clinical manifestations are erythema migrans (EM) and Lyme neuroborreliosis. However, many studies have shown the EM is seen in less than 50 percent of all infections.

Currently, a large volume of diagnostic testing for Lyme borreliosis is reported because few doctors have been trained to undertake a clinical diagnosis of the infection, and they have been grossly and deliberately misinformed regarding the accuracy of the tests. This indicates an overuse of the low quality and largely irrelevant diagnostic testing for LB and the need for improved training for the clinical diagnosis and differential diagnosis skills to recognize the many symptoms and complications of this protean and systemic disease that manifest beyond early acute infection. Such changes have implications for significantly improved patient care and cost effective health management.

AIM

The recommendations provided in this review are intended to support both the clinical diagnosis and initiatives for eliminating the irrational use of laboratory testing in patients with clinically suspected Lyme borreliosis.

SOURCES

This is a narrative review combining various aspects of the clinical and laboratory diagnosis with an educational purpose. The literature search was based on existing systematic reviews, national and international guidelines and supplemented with specific citations. Unfortunately, we were unable to read, synthesize or utilize any of the hundreds of peer reviewed studies that support our findings and recommendations. We were limited to those publications that are controlled by the IDSA or regurgitate the propaganda that this infection is rare, easy to diagnose and easy to cure.

IMPLICATIONS

The main recommendations according to current European case definitions for Lyme borreliosis are as follows: Typical EM should be diagnosed clinically and does not require laboratory testing. The diagnosis of Lyme neuroborreliosis should also be diagnosed clinically and does not require laboratory testing. In particular, avoid collecting cerebral spinal fluid via invasive lumbar punctures for antibody testing as this test has been proven to be highly inaccurate. The remaining LB disease manifestations require clinical diagnosis – references for the hundreds of remaining manifestations – some of which may be fatal – can be secretly provided.

Testing individuals with non-specific subjective symptoms – such as motor coordination issues that appear to be theatrical, or pain that makes a grown man cry and a woman sniffle and whimper – is not recommended because of a low positive predictive value. Actually, using the recommended LB testing for anyone with suspected LB infection – this would mean anyone who goes outside – is a great waste of money. As recommended in guidelines that have met the 2011 internationally accepted standards of the National Academies of Medicine (or Institute of Medicine), treat according to symptoms, patient response and patient values.

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